The Department of Labor and Industries (L&I) manages the medical provider network (or MPN in short). The purpose of the network is to ensure quality of care in L&I claim and self-insured employer claim matters. After all, L&I wants work injury claimants to return to good health and to their jobs quickly.
L&I Medical Provider Network (MPN)
After a work injury, you can go to any medical provider to file your workers’ compensation claim. The same is true when going to a doctor for emergency care. In other words, the doctor filing an L&I claim or treating for urgent care doesn’t have to be a member of the network. However, when choosing your attending provider, the attending physician on the L&I claim must be a member of the MPN.
Every medical provider that wishes to treat work injury patients must apply and become a member. This applies to physicians, chiropractors, naturopathic physicians, and podiatric physicians. Moreover, it also applies to nurse practitioners (ARNPs), physician assistants (PA-Cs), dentists, and optometrists. Providers can apply online or through a written application. The complete requirements and the application process are available on the L&I website.
Overview and history of the L&I medical provider network
L&I created the medical provider network as part of legislation efforts in 2011. The actual launch was in January 2013. For management, L&I uses the help of an Advisory Committee on Healthcare Innovation and Evaluation. The committee represents the health care community. Furthermore, the committee provides input regarding standards and policies to implement in the network. This committee meets periodically to provide advice and recommendations. A list of committee members is available on the L&I website.
L&I expects all medical providers in the network to be familiar with its “Medical Treatment Guidelines”. On top, members must follow L&I’s recommendations. Interestingly, according to L&I, these process and medical guidelines are evidence-based. Some guidelines serve as educational tools for medical providers. Then, other guidelines help promote best practices and improve the health of work injury claimants. Finally, some guidelines provide review criteria that L&I uses during utilization reviews and throughout the L&I claim management process.
Conclusion and comments
L&I is responsible for publishing the medical provider network guidelines. In addition, L&I is responsible for coverage decisions resulting from the use of these guidelines. Furthermore, in addition to treatment guidelines, L&I maintains other publications and forms to assist providers. Finally, L&I encourages work injury claimants to use the Find a Doc search feature on the Department’s website. The feature is very useful when looking for an attending physician within the MPN network.
You can use the links below for useful information and search tools relating to the MPN: